What can occur if the first rib is fractured?

A fractured first rib can be particularly problematic due to its proximity to several vital structures in the thoracic region. The first rib supports the costal arch and protects underlying nerves and blood vessels. When it is fractured, there is a significant risk of injury to the subclavian vessels, which include the subclavian artery and vein. Additionally, the brachial plexus, a network of nerves that innervates the arm and shoulder, runs close to the first rib.

These structures are crucial for both circulation and sensation/movement in the upper limb. A fracture could cause a hematoma or direct trauma to these vessels and nerves, leading to symptoms such as pain, weakness, or loss of function in the arm due to nerve damage, as well as potential vascular complications like hemorrhage or thrombosis.

Considering the serious implications of these injuries, it's clear that while fractures of other ribs may not pose as high a risk to major structures, the first rib's unique anatomical position makes it special regarding potential complications from fracture.